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Amphion Innovations' FireStar: Getting US medical databases on the same page

Transferring patient records to electronic format and making those records "system agnostic" is a key to improving cost efficiency in the notoriously non-cost effect US healthcare system. Amphion Innovations portfolio company FireStar Software is addressing this need, which could result in US government savings of US$80bn a year.


A number of potential mergers have foundered on the rocks of incompatible information technology systems, so imagine the difficulties of getting tens of thousands of medical records systems to talk to each other.

That is a problem that FireStar Software, a portfolio company of intellectual property company Amphion Innovations (LSE:AMP), has been addressing for more than a decade.

With all advanced economies facing the challenge of making the delivery of quality healthcare more affordable, FireStar’s flagship products, EdgeNode and MDMI Runtime, could have a big part to play.

Automation is expected to help make healthcare more efficient, just as it has in the office and in manufacturing. To encourage faster adoption of electronic health information technology in the US, the US government passed the Health Information Technology for Economic and Clinical Health Act in 2009.

Usually shortened to HITECH, the act appropriated US$19.2 billion of funding, and mandated that all one million US healthcare providers establish electronic health records (EHRs), and that these diverse should all be able to easily exchange information – “interoperate” in computer jargon - by 2015.

The first phase, called Meaningful Use 1, required healthcare providers to switch to electronic records of patient data by 2012. This phase has largely been completed.

Meaningful Use 2, the second phase of the HITECH Act, focuses on the interoperability bit, and is where FireStar’s offerings seek to play a crucial part in preventing the well-known “computer says no” problem.

The US government is using a carrot and stick approach to encourage healthcare operators to go digital.

The carrot, available up to the end of 2015, takes the form of cash payments to physicians under the Medicare and Medicaid schemes.

The stick, which is due to come into force after 2015, will take the form of decreased Medicare and Medicaid reimbursements for covered patients.

As a result of these federal initiatives, there are now more than 300 Health Information Exchanges that have formed throughout the country, many of which are focused on facilitating Meaningful Use 2.

It would be fair to say that creating an environment where patient information can be easily transferred between databases is proving a major headache, but the benefits of doing so are clear.

A report from the respected independent research firm RAND suggested that US$80 billion will be saved annually when the hurdle of interoperability is finally overcome.

There are two fundamental technical challenges that must be overcome in order for electronic message exchange to be widely adopted.

  • Firstly, there must be a cost effective way reformat data from one system to another.
  • Secondly, there must be a cost effective way to transport messages between systems.

The key phrase in each case is “cost effective”. It is not difficult to build custom solutions if money is no issue and future scalability and flexibility is not a concern.

For those surgeries that don’t have an Oracle database support team on tap, FireStar Software has developed EdgeNode and MDMI Runtime.

EdgeNode is a low cost, highly functional and easy to implement software messaging platform for implementing an information exchange.

It is a huge breakthrough, as it helps corral the data and transmit it in the most efficient method possible. It adheres to open standards and allows for low-cost, highly accurate, data conversion.

FireStar’s MDMI Runtime, meanwhile, is being offered to the market as an open source, standard, product. As with companies such as US$9bn valued Red Hat, which provides free software to clients, the company will seek to generate revenue from an open source product by providing general support, service, upgrades, and add-ons.

This level of hand-holding, a variant of the "freemium" model, could generate hundreds of millions of dollars annually.

The company’s proprietary and patent protected product, EdgeNode, is a robust low-cost message delivery platform, and is designed to work with and incorporate MDMI.

Working together, EdgeNode and MDMI are the keys to effective health data exchange; in Star trek terms , they are the brains behind the universal translation facility.

FireStar, a Boston-based software development company, has been nurtured through its formative years by AIM-listed Amphion Innovations (LON: AMP), which owns around 20% of the business.

Amphion is very excited by the market opportunity open to FireStar, where its low cost offerings should appeal to small, undercapitalised clinics and physician’s practices; not that the products would not also appeal to the large, big budget hospitals, whose budgets are also under pressure.

Even at price points for EdgeNode as low as US$100 a month, the revenue opportunity from these two complementary products runs well over US$1 billion a year, Amphion believes.

The key to widespread adoption of these solutions will be the adoption of MDMI as a standard by the key agencies and opinion leaders. This now seems to be happening.

For example, FireStar was recently invited to present and demonstrate its technology at the recent HL7 conference in Atlanta.

Health Level Seven International (HL7) is the global authority on data standards for interoperability of health information technology, with members in 55 countries.

The feedback from this conference was extremely encouraging and a number of exciting opportunities have emerged from the conference.

Discussions are now taking place with the Office of the National Coordinator (a division of the Department for Health and Human Services in the US) and other member organisations.

In addition, FireStar continues to work with large healthcare groups who are leading the way in the adoption and implementation of electronic records exchange.

The future looks bright. Amphion and FireStar have made a substantial investment in these technologies and products.

MDMI was recently described by one industry leader as a “game changer” and if it is adopted as the standard, the demand for FireStar’s products and services should grow substantially, offering a very attractive return on investment, while also solving one of the most pressing problems facing the US healthcare industry today.

Richard Morgan, chief executive of Amphion and chairman of FireStar, said: “After over ten years of investment in the development of these important technologies, it is gratifying to see FireStar’s products being embraced by the thought leaders in the IT revolution that is starting to sweep the healthcare industry.

“These changes should bring important benefits to patients and payers and offer the prospect of an attractive return on investment for FireStar and Amphion shareholders alike.”

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